Curative effect and prognostic impact of radical resection assisted by transcatheter arterial chemoembolization in treatment of intrahepatic cholangiocarcinoma

• Main Author: TANG Xiao
• Format: Article
• Language: zho
• Published: Editorial Department of Journal of Clinical Hepatology 2015-02-01
• Series: Linchuang Gandanbing Zazhi
• Subjects: intrahepatic cholangiocarcinoma; hepatectomy; chemoembolization; therapeutic; prognosis
• Online Access: http://www.lcgdbzz.org/qk_content.asp?id=6276&ClassID=11415232
• ISSN: 1001-5256; 1001-5256

ObjectiveTo investigate the curative effect and prognostic impact of radical resection assisted by transcatheter arterial chemoembolization (TACE) in the treatment of intrahepatic cholangiocarcinoma (ICC). MethodsThe clinical data of 80 patients with ICC who were admitted to the Department of Hepatobiliary Surgery in our hospital from January 2008 to December 2010 were retrospectively analyzed. Thirty-five patients in the control group received radical resection, while forty-five patients in the observation group received adjuvant TACE therapy following radical resection. The curative effect and survival time were compared between the two groups. Comparison of continuous data between the two groups was made by t test, and comparison of categorical data was made by chi-square test. ResultsThe observation group had significantly lower serum levels of alpha-fetoprotein, carcinoembryonic antigen, carbohydrate antigen 19-9, and alanine aminotransferase than the observation group at 6 months after surgery (47.35±13.76 vs 83.54±24.17 μg/L, t=19.58, P＜0.05; 30950±125.55 vs 37585±136.77 μg/L, t=101.33, P＜0.05; 20.86±10.38 vs 34.18±8.55 ng/ml, t=29.46, P＜0.05; 25.44±819 vs 58.56±22.58 U/L, t=32.25, P＜0.05). The 1-year, 2-year, and 3-year survival rates in the observation group were significantly higher than those in the control group (χ2=11.43, P＜0.05; χ2=20.15, P＜0.05; χ2=9.87, P＜0.05). The mean survival period was significantly longer in the observation group than in the control group (t=15.38, P＜0.05). According to the analysis of factors influencing the survival period in patients with ICC, patients with a tumor size larger than 5.0 cm, a low degree of differentiation, and metastasis had a significantly lower long-term survival rate and a significantly shorter mean survival period than other patients (P＜0.05). ConclusionThe adjuvant TACE therapy after radical resection is a safe and effective method in the treatment of ICC. The tumor size, degree of differentiation, portal vein tumor thrombus, and metastasis have a strong prognostic impact.